Photo Credit: Mohammed Haneefa Nizamudeen
Missed or undiagnosed cirrhosis may be a risk factor for cognitive decline, according to a study published online Jan. 31 in JAMA Network Open.
Jasmohan S. Bajaj, M.D., from Virginia Commonwealth University in Richmond, and colleagues examined the prevalence and risk factors for undiagnosed cirrhosis and possible hepatic encephalopathy (HE) in veterans with dementia in a retrospective cohort study conducted between 2009 and 2019 using data from the Veterans Health Administration and two separate validation cohorts. Data were included for 177,422 U.S. veterans with dementia.
The researchers found that 5.3 and 10.3 percent of the veterans had a Fibrosis-4 (FIB-4) score greater than 3.25 and greater than 2.67, respectively. FIB-4 greater than 3.25 was associated with older age, male gender, congestive heart failure, viral hepatitis, Alcohol Use Disorders Identification Test score, and chronic kidney disease in multivariable analysis (odds ratios, 1.07, 1.43, 1.48, 1.79, 1.56, and 1.11 respectively); inverse associations were seen for White race, diabetes, hyperlipidemia, stroke, tobacco use disorder, and rural residence (odds ratios, 0.79, 0.78, 0.84, 0.85, 0.78, and 0.92, respectively). For FIB-4 greater than 2.67, findings were similar. A similar percentage of high FIB-4 scores was seen on a local validation cohort of dementia patients (4.4 to 11.2 percent).
“In a national veterans cohort of patients with dementia, 5 to 10 percent of the patients have laboratory values suggestive of possible undiagnosed cirrhosis that could implicate HE as a contributor to overall cognitive impairment,” the authors write.
Two authors disclosed ties to the pharmaceutical industry.
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